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Review Article
Neurology
Transient splenial lesions of the corpus callosum and infectious diseases
Kyu Sun Yum, Dong-Ick Shin
Acute Crit Care. 2022;37(3):269-275.   Published online August 17, 2022
DOI: https://doi.org/10.4266/acc.2022.00864
  • 20,157 View
  • 444 Download
  • 9 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Transient splenial lesion of the corpus callosum can be observed in various diseases such as cancer, drug use, metabolic disorders, and cerebrovascular disorders, as well as in patients with infectious diseases. During the coronavirus disease 2019 (COVID-19) pandemic, there were increasing reports of these lesions being detected on brain imaging tests performed in patients with neurological symptoms. On brain magnetic resonance imaging, findings suggestive of cytotoxic edema are observed in the splenium; these are known to disappear with improvement of clinical symptoms. Cytokinopathy caused by infection increases the permeability of the blood–brain barrier and activates the glial cells of the brain to induce cytotoxic edema. Most patients have a good prognosis. The causes, mechanism, diagnosis, treatment and prognosis of transient splenial lesions of the corpus callosum will be summarized in this review.

Citations

Citations to this article as recorded by  
  • Parvovirus B19 encephalitis in adults: a case report from Vietnam
    Nguyen Dang Duc, Lam Nguyen Hong Anh, Lam Nguyen Hong Khanh, Nguyen Dang Bach
    Virology Journal.2026;[Epub]     CrossRef
  • Neurological and neurodevelopmental outcomes in neonates and children after maternal chikungunya infection in pregnancy: a systematic review and meta-analysis
    Liyan Zhou, Chenyuan Qin, Jie Deng, Yan Xing, Hongguang Chen, Daniel R. Lucey, Jue Liu
    eClinicalMedicine.2026; 94: 103888.     CrossRef
  • Cytotoxic lesion of the corpus callosum after gamma hydroxybutyrate withdrawal: a case report
    Kuang Heng Wang, Kuei Hong Kuo, Hsien Hsueh Shih, Yi Ju Pan
    Journal of Addictive Diseases.2026; : 1.     CrossRef
  • Cytotoxic lesions of the corpus callosum: diagnostic challenges and treatment strategies in a case series and literature review
    R. Priya Dharshini, Praveen K. Sharma, GR Nivashini, Jaypradha Saravanan, Paarthipan Natarajan
    Romanian Journal of Neurology.2026; 25(2): 221.     CrossRef
  • Case report: Re-evaluating reversibility of cytotoxic lesions of the corpus callosum
    Victoria Vold, Stein-Helge Hansen Tingvoll, Mona K. Beyer, Kaja Nordengen
    Frontiers in Neuroimaging.2025;[Epub]     CrossRef
  • Reenvisioning Cytotoxic Lesions of Corpus Callosum in Light of Coronavirus Disease-2019: Review with Related Concepts
    Udit Chauhan, Khanak K. Nandolia, Rahul Dev
    Journal of Medical Evidence.2025; 6(2): 149.     CrossRef
  • Tuberculous Meningitis in a Child: A Rare Presentation of Cytotoxic Lesion of the Corpus Callosum
    Ny Thi Hong Tran, Nhung Thi Hong Nguyen, Uyen Phuong Vo, Julie Huynh
    Tropical Medicine and Infectious Disease.2025; 10(4): 96.     CrossRef
  • COVID‐19‐Associated Cytotoxic Lesions of the Corpus Callosum in Chinese Patients: A Retrospective Study
    Chenyi Wan, Menghua Li, Yanyan Yu, Si Luo, Daojun Hong, Meihong Zhou, Yu Zhu
    Brain and Behavior.2025;[Epub]     CrossRef
  • Cytotoxic Lesion of the Corpus Callosum Associated with 5-Fluorouracil: A Case Report and Review of Literature
    Maral Martin MİLDANOĞLU, Banu KARAALİOĞLU, Ebru ENGİN DELİPOYRAZ, Mehmet Haluk YÜCEL, Ömer Fatih ÖLMEZ
    Journal of Oncological Sciences.2025;[Epub]     CrossRef
  • A 10-year-old girl with meningitis retention syndrome and reversible splenial lesion: A case report
    Chung-Hao Wang, Chi-Nan Huang, Pei-Wei Wang
    Pediatrics & Neonatology.2024; 65(2): 204.     CrossRef
  • Legionella‐induced dysarthria and rhabdomyolysis with acute renal failure achieving recovery
    Husam El Sharu, Soban Ahmad, Hunter Coore
    Clinical Case Reports.2024;[Epub]     CrossRef
  • Rickettsial infection causing non-aneurysmal subarachnoid hemorrhage with transient corpus callosum lesion
    Zahraa Noureddine El Moussaoui, Zahraa Saker, Hasan Rahhal, Ali Nasserdine, Mahmoud Younes
    Journal of Medicine, Surgery, and Public Health.2024; 2: 100093.     CrossRef
  • Cytotoxic lesions of the corpus callosum due to FOLFIRINOX chemotherapy
    Mafalda Soares, Sara Rosa, Sofia Bettencourt, Rita Ferreira, Mariana Sardinha, Margarida Dias, Bruno Cunha
    Brain Disorders.2024; 15: 100157.     CrossRef
  • Contrasting association pattern of plasma low-density lipoprotein with white matter integrity in APOE4 carriers versus non-carriers
    Zhenyao Ye, Yezhi Pan, Rozalina G. McCoy, Chuan Bi, Chen Mo, Li Feng, Jiaao Yu, Tong Lu, Song Liu, J. Carson Smith, Minxi Duan, Si Gao, Yizhou Ma, Chixiang Chen, Braxton D. Mitchell, Paul M. Thompson, L. Elliot Hong, Peter Kochunov, Tianzhou Ma, Shuo Chen
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Original Articles
Emergency/Neurology
Brain Magnetic Resonance Imaging in Patients with Favorable Outcomes after Out-of-Hospital Cardiac Arrest: Many Have Encephalopathy Even with a Good Cerebral Performance Category Score
Woo Sung Choi, Jin Joo Kim, Hyuk Jun Yang
Korean J Crit Care Med. 2015;30(4):265-271.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.265
  • 9,836 View
  • 111 Download
AbstractAbstract PDF
Background
The aim of this study was to retrospectively evaluate and analyze the brain magnetic resonance imaging (B-MRI) findings of patients with a favorable neurological outcome following cerebral performance category (CPC) after out-of-hospital cardiac arrest (OHCA) at single university hospital emergency center.
Methods
Patients with return of spontaneous circulation (> 24 h) after OHCA who were older than 16 years of age and who had been admitted to the emergency intensive care unit (EICU) for over a 57-month period between July 2007 and March 2012 and survived with a favorable neurological outcome were enrolled. B-MRI was taken after recovery of their mental status.
Results
Fifty-two patients among the 305 admitted patients had a good CPC, and 33 patients’ B-MRI were analyzed (CPC 1: 26 patients, CPC 2: 7 patients). Among these, 18 (54.5%) patients had a normal finding on B-MRI. On the other hand, ischemia/infarction/microangiopathy compatible with hypoxic-ischemic encephalopathy (HIE) were found on various brain areas including subcortical white matter (7/13), cerebral cortex, central semiovlae, basal ganglia, putamen, periventricular white matter, and cerebellum.
Conclusions
Survivors with a favorable neurological outcome from OHCA showed HIE on B-MRI, especially all of the patients with a CPC 2. More detail neurologic category including brain imaging would be needed to categorize patients with favorable outcome after OHCA.
Efficacies of Somatosensory Evoked Potential and Diffusion-Weighted Magnetic Resonance Imaging as Predictors of Prognosis for Patients Experiencing Coma after Cardiac Arrest
Sang Hee Chae, Soo Hyun Kim, Se Min Choi, Seung Pill Choi, Kyu Nam Park
Korean J Crit Care Med. 2013;28(4):300-308.
DOI: https://doi.org/10.4266/kjccm.2013.28.4.300
  • 4,572 View
  • 27 Download
  • 1 Crossref
AbstractAbstract PDF
BACKGROUND
The aim of this study was to examine the efficacies of somatosensory evoked potential (SEP) and diffusion-weighted magnetic resonance imaging (DWI) in predicting the clinical prognosis of comatose patients following cardiac arrest.
METHODS
Forty-one patients resuscitated from out-of hospital cardiac arrest (OHCA) were retrospectively studied. After return of spontaneous circulation (ROSC), SEP was conducted between one and three days after resuscitation, and DWI was conducted within five days of resuscitation. SEP was classified into three grades: normal, delayed conduction or unilateral loss of the N20 peak, and bilateral loss of the N20 peak. Bilateral loss of the N20 peak was considered a predictor of poor prognosis. For DWI, diffuse signal intensity (SI) abnormality in the cerebral cortex or abnormality in other brain areas in addition to the bilateral cerebral cortex was taken as a predictor of poor prognosis. For patient clinical prognosis, the Glasgow-Pittsburgh Cerebral Performance Category (CPC) was used to evaluate neurological results at the time of discharge. Resulting CPC scores of 1 and 2 were considered as a favorable prognosis, and scores of 3, 4, and 5 were considered as a poor prognosis. Sensitivity, specificity, positive predictive value, and negative predictive value for the prediction of poor prognosis were analyzed for each test individually and for the combination of the two tests.
RESULTS
Among the 41 subject patients, 31 underwent SEP, 30 underwent DWI, and 20 underwent both tests. The prognosis predictor of SEP (bilateral loss of the N20 peak) predicted poor prognosis with 56.5% sensitivity, 100% specificity, 100% positive predictive value, and 44.4% negative predictive value. The prognosis predictor of DWI (diffuse SI abnormality in the cerebral cortex or abnormality in other brain areas in addition to the bilateral cerebral cortex) predicted poor prognosis with 85% sensitivity, 100% specificity, 100% predictive value, and 76.9% predictive value. For patients who underwent both tests, the sensitivity and negative predictive value for the prediction of poor prognosis increased to 92.3% and 87.5%, respectively, and the specificity and positive predictive value were maintained at 100%.
CONCLUSIONS
The accuracy of poor prognosis prediction for patients in prolonged comas after resuscitation is enhanced by combining the results of SEP and DWI along with the individual results of each test.

Citations

Citations to this article as recorded by  
  • The Effect of Transcranial Direct Current Stimulation and Functional Electrical Stimulation on the Lower Limb Function of Stroke Patients
    Xiao-Hua Zhang, Tao Gu, Xuan-Wei Liu, Ping Han, Hui-Lan Lv, Yu-Long Wang, Peng Xiao
    Frontiers in Neuroscience.2021;[Epub]     CrossRef
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